1st BBL 2020 then another to improve lumps, dimples - how do I get my saddle bags fixed? (Photo)

Question

I got my first bbl in 2020. Once the fat settled I noticed I had two lumps and dimples on the side of my hips. I went in for another rd to improve them and the doctor made them worst. I am so insecure about my body even more now. I just want my body fixed. I don’t feel myself anymore. I can’t even wear a bath suit. I just need to know if this could be fixed and what to do. I’ve been focusing on losing weight and getting down to a weight that will help. HELP PLEASE. I AM IN NEED

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photo. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

You are in good company with many others who had high hopes for BBL but instead received disappointing results (lumpiness, unevenness, lack of projection in the central and/or lower buttock, insignificant hip augmentation, post-deflation sagging, fatty necrotic cyst or scar tissue, etc.) as most of the fat melts away. It is not quite as much the quality of the doctor nor liposuction technique but rather the quality of the procedure that is a large part of the problem.  Thus, going back for additional rounds of BBL most often produces the same disappointing results but at another financial loss.   Beware, if a surgeon asks you to purposely gain weight (i.e. fat) before BBL, know that the fat you lose first as you get back to your baseline weight after surgery is that very same fat that was transferred into your buttock, hence your new buttock shrinks first, the fastest, and the most...so please do not fall victim to this recommendation.

Fillers, such as Sculptra and hyaluronic acids,  for augmentation of the buttock/hips are a rip-off, period!

Buttock/hip implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the hips and central buttock, and often help smoothing out lumpiness. Occasionally a lower buttock tuck may be advantageous for lower buttock fold asymmetries and/or sagging.  When considering buttock implants make sure that the surgeon is going to be placing the implants within gluteus muscles , (a.k.a. “intramuscular pocket”), and that they are using anatomically correct, oval-shaped implants, such as Stanton Anatomic ®️ implants. 
Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in these buttock implants so be sure to consult with one that is reputable and experienced. Unfortunately you may have to travel long and far away from home to find this particular surgeon. Glad to help.

Daniel Barrett, MD · Answer

Dear Compassionate1518,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

John L. Burns Jr., MD · Answer

In my opinion you have too much lateral fullness.  Removing this would help and give you a less square appearance.  The cellulite is difficult and might improved slightly with BodyTite.

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent quality, liposuction and fat transfer results is more difficult than most people realize. The number of plastic surgeons who have truly mastered these procedures are in a minority.
There are providers who feel that Liposuction of the thighs is a good idea in order to make the buttocks look bigger. This is a very unnatural appearance that is counter to the natural, female, S-curve, a.k.a. Coke bottle, a.k.a. hourglass figure that should be the ideal endpoint. I called the outcome, the lollipop look, and the mistake is generally inappropriate fat removal from the upper thigh.
Revision Work is many times more difficult than primary liposuction and fat transfer procedures. Considering how much variation there is in skill for this type of work, and considering that revision work is much more difficult the importance of finding the best provider becomes more important than ever.
To find the best provider, I generally recommend patients have multiple in person, consultations, avoiding virtual consultations. I generally recommend people avoid traveling long distances for elective surgical procedures, unless that involves traveling for in person, consultations and follow up visits. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of the previous patients who had similar body characteristics to your own. And experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. And highly experienced surgeon she did in fact have 100s or preferably thousands of before and after pictures to choose from. Being shown a handful of pre-selected images, representing the best results of the providers career is insufficient to get a clear understanding of what average results look like in the hands of that provider or how many of these procedures they’ve actually performed. There’s no correct number of consultations needed to find the best provider. The more consultation scheduled a more likely you are to find the best provider for your needs. The biggest mistake patients make a scheduling, one consultation and then having surgery or even worse, scheduling a single virtual consultation and then scheduling surgery. 
It is the patient responsibility to vet plastic surgeons to confirm. They have the skill an experience to perform these procedures well. Being bored, certified in plastic surgery with years of experience in an overall good reputation, does not mean if somebody has mastered any one single operation especially not Liposuction and fat transfer, which are difficult procedures to do well.
Restoring your figure to some thing that looks normal is going to be difficult. This is especially true, because fat was removed from your thighs that should not have been removed. Reducing grafted fat of your buttocks should not be that difficult, but restoring the deficit just below your buttocks is going to be difficult and may require a number of operations. Anytime patients sign up for revision surgery you need to recognize things can be made worse if you’re not in the hands of a sufficiently talented provider.
Finding the Right provider can require having quite a few consultations. I generally recommend people start the process by having at least five consultations before considering choosing a provider. In cases of disfigurement and correcting poorly done work, you may need to have many more consultations until you find the right provider, who can Improve your contour. This may also require more than one procedure. Some of the very best plastic surgeons may also be unmotivated to Taegen Revision Work from other providers bad outcomes. All of these variables, make revision work after poorly done, plastic surgery, challenging and difficult.
I would be apprehensive of the providers who think this is easy to fix for those who believe that some new technological device is the secret to improving your outcome. There are no nonsurgical options that are going to improve your outcome.
I wish I could be a little bit more optimistic in my response. I’m sorry you find yourself in this position and wish you the very best in finding the right provider to guide you through the process.
Best,
Mats Hagstrom, MD

1st BBL 2020 then another to improve lumps, dimples - how do I get my saddle bags fixed? (Photo)

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